Journal of Case Reports and Medical History
Case Report
protect him from renal failure, whereas he had been
During a routine examination, a 14-year-old boy with
discharged with normal CK levels a few days later.
extremely elevated ALT, and AST and CK (3000 IU) were
Three weeks before the following check-up the patient had
seen. In the further check-up, 10 days later a further elevation
started his work out again, without consuming any
of CK was measured.
supplements. He showed slightly elevated CK levels around
The young patient with an athletic body stated to work out
450 U/l, which can be seen as normal according to a higher
regularly, up to five times a week, and four hours a day. In
amount of muscle cell destruction due to his workout.
addition, he took a nutrition supplement containing vitamins
The pivotal question is, if there is any connection between the
and creatinine. He did not report any subjective disorders.
consumption of the mentioned supplements and a destruction
The following three days, an increase of CK up to 17230 U/l
of muscle cells.
occurred, whereby the ratio of CK-MB as less than 1%. The
In this case creatine is a main part of the consumed
highest measured Myoglobin level was 1728 ng/ml.
substances. It is often consumed by athletes, usually in
The patient developed an infection a few days before the
amounts of up to 20g daily. Typical side effects are the gain
highly elevated levels were measured but did not report
of body mass, muscle cramps, renal and gastrointestinal
about any pain or disorders.
disorders [1]. Several other side effects have been described,
As advised, he stopped his work out and consummation of
but
food supplements, with a dramatic decrease of CK within a
monohydrate is considered to be harmless.
few days. He received intravenous fluids and diuretics to
The contents of the three supplements consumed are
nevertheless
the
consumption
of
oral
creatine
mentioned in the following table. Supplement 1 Contents Protein Carbohydrates Fat Vitamins Ascorbic acid Niacin Vitamin E
per 100g 30 g 64 g 1g 60 mg 18 mg 10 mg
Pantothenic acid Vitamin B6
6 mg 2 mg
Vitamin B2 Vitamin B1
1.6 mg 1.4 mg
Folic acid Biotin
0.2 mg 0.15 mg
Vitamin B12
1 mg
Supplement 2 Contents Carbohydrates Of which starch Of which lower sugar types Protein Fat
per 100g 92 g 90 g < 0.5 g < 0.5 g < 0.5 g
Supplement 3 Contents Creatine monohydrate
per 100 g 100 g
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